小儿肺炎840例常见病原分析

Pneumonia in children: common etiology analysis of 840 cases.

目的 探讨小儿肺炎常见病原在不同地域、不同季节的流行情况以及常见病原的中医证候分布。方法 对2 0 0 2年3月至2 0 0 3年1 2月收治的840例肺炎患儿血清,用颗粒凝集法(PA)检测肺炎支原体(MP)抗体,ELISA法检测腺病毒(ADV)、呼吸道合胞病毒(RSV)、流感病毒(IV)的病毒抗体。结果 共测得病毒感染阳性病例3 0 3例,病毒阳性毒株3 75株,总阳性率为3 6 .1 % ( 3 0 3 / 840 ) ;肺炎支原体在3 ～7岁学龄前儿童中阳性率最高,为43. 6% ,<3岁组病毒阳性率最高,RSV、ADV、IV分别为46. 2 % ,63 . 1 %和56. 4% ;广州地区病毒阳性检出率为54 . 2 % ,上海地区为51 . 3 % ,辽宁地区的病毒阳性检出率为1 6 .0 % ;黑龙江地区为47. 5% ,成都地区为45. 6%。东北、成都地区在不同的季节病原分布无明显差异性(P >0 .0 5) ,上海、广州地区在不同的季节病原分布有明显差异性(P<0 .0 5)。不同的病原在中医证型间的分布无明显差异性(P >0 . 0 5)。结论 支原体肺炎在学龄前儿童中患病率最高,病毒性肺炎幼儿患病率最高;病毒阳性检出率南方略高于北方;上海地区MP肺炎以夏季发病较多,RSV和ADV肺炎均在冬季多见,IV肺炎在春季明显增多,广州地区MP肺炎在夏春季发病较多,RSV肺炎夏季多见,ADV肺炎多在冬季发病,IV肺炎在冬春季患病率增?

Objective To investigate the common etiology epidemiology characteristics of pneumonia in children of different regions and in different seasons and investigate the distribution regularity of TCM's syndrome of different pathogens. Methods To 840 cases of pneumonia in children, PA method was applied to detect MP antibody and ELISA method was applied to detect the antibody of ADV,RSV,IV. Results Etiology was confirmed in 303 cases and 375(36.1%) strains were found . The positive rate of MP was the highest in age of 3～7 ,which was 43.6%,the viral positive rates were higher in group of younger than 3 years old, which were 46.2%(RSV), 63.1%(ADV) and 56.4%(IV);the viral etiology positive rate was 54.2% in Guangzhou, 51.3% in Shanghai, 16.0% in Liaoning, 47.5% in Heilongjiang and 45.6% in Chengdu.The different distribution of etiology in different seasons not obvious in northeastern area and Chengdu (P>0.05),the difference of that was obvious in Shanghai and Guangzhou .There was no obvious difference in different syndrome of different etiology. Conclusions The incidence of MP pneumonia is highest in preschool age children and the incidence of viral pneumonia is highest in young children; the positive rate of virus in the south is higher than in the north. The incidence of MP pneumonia is higher in summer while RSV and ADV pneumonia is higher in winter in Shanghai and the incidence of IV pneumonia is higher in spring. The incidence of MP pneumonia is higher in both spring and summer in Guangzhou, RSV pneumonia is higher in summer,and ADV and IV pneumonia in winter.